Roll-Under (Or Fold-Under) Flap for Release of Earlobe Contractures

EDITORIAL COMMENT

As pointed out by the author, this technique is also applicable to secondary face lifts where there has been a downward pull and distortion of the earlobe.

The roll-under (or fold-under) flap for rounding of a contracted earlobe has been very useful in this author’s experience, particularly in secondary face-lifts. When the original face-lift has been performed and it pulls down on the earlobe, a tight, tapered lobe often follows. It is unsightly and makes difficult a secondary meloplasty without an obvious scar below the lobe. Some lobes are naturally tapered, and these can be rounded as well, both to simplify wearing earrings and to hide the scar at the junction of lobe to cheek.

INDICATIONS

The procedure is probably used in one patient of four in whom the author performs a meloplasty, either to avoid tapering the borderline lobe or to correct a lobe that is already tapered or contracted. Obviously, the need for performing this as a secondary procedure will be decreased greatly by care in the original surgery to give adequate support to the anterior and posterior flaps at a higher level, so that no pull is carried to the earlobe itself.

FIGURE 94.1 A,A’: Outline of flap, rectangular in shape, below and slightly behind the ear and based on the lobe itself. B,B’: Roll-under (or fold-under) of the flap medially and upward to round the earlobe. In isolated lobe reconstruction, the donor defect may be closed as a simple linear closure below the earlobe and slightly behind the angle of the jaw. C,C’: Use of the roll-under flap to round the earlobe along with a meloplasty. Note that the incision was carried upward in front of the ear and upward behind the ear, bringing the cheek and neck tissues upward to close the defect against the newly rounded lobe rather than closing a donor defect below the lobe. Obviously, the incisions would extend farther superiorly with the usual meloplasty.

Only gold members can continue reading. Log In or Register to continue